This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The purpose of this study is: 1. To evaluate the effect of darbepoetin on reticulocyte count, hematocrits, erythropoietin concentrations, and transfusion requirements in premature infants, compared to standard rHuEpo dosing and compared to placebo/sham dosing. 2. To evaluate the neurodevelopmental outcome of infants at age 18 to 22 months receiving darbepoetin compared to standard rHuEpo dosing and compared to placebo/sham dosing, and correlate neurodevelopmental outcomes with erythropoietin concentrations.